Exposure of children to glyphosate in Morocco: Urinary levels and predictors of exposure.

Glyphosate is one of the most frequently used organophosphorus plant protection products worldwide, and has recently been classified as probably carcinogenic to humans by the International Agency for Research and Cancer (IARC). We aimed to evaluate the urinary levels of glyphosate and its metabolite aminomethylphosphonic acid (AMPA) in Moroccan children, to identify the main predictors and to perform a risk assessment. Data was collected during a cross sectional study of 48 children from an intensive agricultural area. Measurements included a questionnaire on life-style, socio-demographic and herbicide exposures. Urinary glyphosate and AMPA were extracted using solid phase extraction (SPE) and analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Overall, glyphosate and AMPA were detected in 73% and 75% of urine samples, respectively. The mean concentrations were 0.97 µg L-1 (2.06 µg/gcreatinine) for glyphosate and 0.79 µg L-1 (1.52 µg/gcreatinine) for AMPA. Children younger than 5 years had a higher AMPA and glyphosate urine concentration (mean = 2.24 µg L-1; estimation coefficient (EC) = 1.39; 95% CI: 0.54-2.24) (mean = 4.05 µg L-1; EC = 2.92; 95% CI: 1.68-4.15), respectively, than children aged 6-12. Children living near the pesticide spraying fields (<50 m) had 14.91 µg L-1 and 2.35 µg L-1 more glyphosate and AMPA, respectively, than children living in urban counties (95% CI: 8.14-20.91 for glyphosate and 95% CI: 0.55-4.14 for AMPA). AMPA concentration varied significantly with the source of drinking water, AMPA was higher among children that used water from open water sources (mean = 1.49 µg L-1; EC = 2.98; 95% CI/0.67-5.78) compared to those using water from closed water sources. There were also non-significant associations found, such as total household net income, current parental job description, and dietary intake. With the regard to the health risk assessment, estimated daily intake (EDIs), hazard quotient (HQs), and a hazard index (HI) were calculated. The GMs of EDI were 4.38 and 2.26 µg/kg of body weight BW/day for glyphosate and AMPA, respectively. The HQs were calculated considering 0.5 mg/kg BW/day as an acceptable daily intake (ADI), which EFSA has established as a health-based reference value for both analytes. The value obtained were lower than 1, and therefore, low health risk due to glyphosate and AMPA was expected for the target population under the study. This study provides further evidence on factors associated with glyphosate exposure, especially in developing countries.

Prevalence and risk factors associated with chronic kidney disease in Moroccan rural communes: Fez-Meknes region.

BACKGROUND AND AIMS: Chronic kidney disease is a worldwide public health issue. It can be a serious problem, especially in developing countries including Morocco. However, few studies have explored the factors influencing chronic kidney disease in this country. Hence, using the definitions proposed by Kidney Disease Improving Global Outcomes in 2012, we have conducted this study to establish the prevalence and risk factors of chronic kidney disease particularly in rural communities in the Fez-Meknes region. METHODS: Weight, height, blood pressure, proteinuria, hematuria, plasma creatinine, estimated glomerular filtration rate (using the Modification of Diet in Renal Disease formula), and fasting glycemia were measured. Abnormal results were controlled within two weeks; estimated Glomerular filtration rate was retested at 3 months. Furthermore, to determine the factors associated with chronic kidney disease, multivariate logistic regression was used. RESULTS: A total of 431 patients participated in the study; the prevalence of confirmed proteinuria, hematuria, and reduced estimated Glomerular filtration rate was 5.3%, 1.8%, and 3%, respectively. Overall, chronic kidney disease was found to be present in 6.5% of the population. Chronic kidney disease 1 and 2 accounted for 32.1% and 21.4% of the overall chronic kidney disease population, respectively, while chronic kidney disease 3 accounted for 46.4% (3A: 38.2%; 3B: 7.14%). Chronic kidney disease 4 and 5 were not present in the total chronic kidney disease population. Chronic kidney disease was strongly linked with advanced age (OR 2.65; 95%CI: 1.05-6.65), hypertension (OR 2.41; 95%CI: 1.03-5.63), agricultural occupation (OR 1.02; 95%CI: 1.00-1.04) and contact with Agrochemicals (OR 1.40; 95%CI: 0.81-2.71). CONCLUSIONS: It is important to note that screening for kidney damage and being aware of the risks linked to it, is key for the early detection and management of chronic kidney disease; they are also crucial to provide in a database for the development of a national prevention policy.

Factors Associated with COVID-19 Vaccine Acceptance in Morocco: Applying the Health Belief Model.

To identify factors that influenced Moroccans' intention to get a COVID-19 vaccine, a cross-sectional survey among a Moroccan sample was conducted based on Health Belief Model constructs. Participants' sociodemographic characteristics, perceived susceptibility, perceived severity, perceived barriers, perceived benefits, self-efficacy, cues to action, and intention to receive vaccine data were collected and analyzed using a structural equation model (SEM). The survey was completed by 3800 individuals; 57.2% were men, 44.5% were aged 30 to 44, and 44.6% were married. After controlling for confounders, being a woman and having a chronic disease were associated with higher acceptance of the COVID-19 vaccine. The strongest predictor for the intention of receiving a vaccine was participants who were married. Most of the HBM constructs were shown to be significantly associated with vaccine acceptance. Susceptibility and Benefits were the strongest predictors of acceptance of the COVID-19 vaccine (standardized path coefficient, SPC = 0.23), followed by Severity (SPC = 0.22). Conversely, given the negative correlation between barriers and intention (SPC = -0.08), it is necessary to maintain a high level of transparency regarding the vaccines' safety. Our study provides guidance for an implementation of vaccination strategies, intending to bolster the overall COVID-19 immunization program.

MAROCOVID: Snapshot Monitoring of Knowledge and Perceptions of Safety Behaviors during the COVID-19 Outbreak in Morocco.

To assess whether knowledge, attitude, and perceptions of the COVID-19 pandemic predicted changes in behaviors among the general Moroccan population, a cross-sectional online survey was conducted between 30 March and 20 April involving a total of 14,157 participants. The statistical analysis of the data included univariate and multivariate logistic regression analysis. Our results suggest that less than ten days after the Moroccan government announced "Health state of Emergency" response to the COVID-19 outbreak, public knowledge, attitude and responses to the pandemic were relatively high. More than half the respondents (63.2%) reported that they complied with more than five of nine recommended safety measures, including avoiding going out (93.2%), and frequent handwashing with soap and water (78.2%). Factors associated with an increased likelihood to adopt safety measures included perceptions that COVID-19 was a human health risk, the pandemic will continue for a long time, availability of clear information, and a lack of medicine. The largest predictor of safety behavior change was age; participants older than 55 were more likely to adopt recommended safety behaviors. Although knowledge and perception among the general public was reasonable, more encouragement from government via health education programs is needed to maintain appropriate behaviors.

Health and ecological risk assessment based on pesticide monitoring in Saïss plain (Morocco) groundwater.

In many countries, including Morocco, groundwater contamination with pesticides such as globally banned organochlorides (e.g., dichlorodiphenyltrichloroethane (DDT)) and some accredited organophosphates and pyrethroids poses ecological and human health risks. To assess these risks, we herein monitored pesticides in Saïss plain groundwater (Morocco) during the summer of 2017 and the winter of 2018 using polar organic chemical integrative samplers. The two types of passive samplers were deployed in 22 traditional wells for 14-20 days and subjected to solid-phase extraction. The extracts were analyzed by gas chromatography-mass spectrometry and liquid chromatography-tandem mass spectrometry using a multiresidue method, and 27 pesticides were detected in total. In the summer campaign, 22 pesticides with individual concentrations ranging from

Farmers' Knowledge, Attitudes, and Perceptions Regarding Carcinogenic Pesticides in Fez Meknes Region (Morocco).

Pesticides play an important role in the improvement of agricultural production, but their use may result in adverse effects on the environment, consumers, and farmers' health. As there are limited data focusing on the factors influencing safety behavior toward pesticide use in Morocco, we conducted a cross-sectional survey in 15 rural communities of Morocco's Fes Meknes region to assess the attitudes, knowledge, and practices regarding pesticide use. A structured questionnaire was completed, containing the data of the interviewed farmers, their behavior towards safety measures, the type of active ingredient used, as well as the perception of risks to their own health following exposure to pesticides by the existence of chronic, self-perceived symptoms. Non-probability (empirical) sampling with the quota method was carried out, which consists of constructing the sample. Results showed that most respondents have not been trained in the application of pesticides, with almost half of the farmers using a category of pesticides which are classified by the International Agency for Research on Cancer as probable human carcinogenic (i.e., Glyphosate, Malathion). In terms of pesticide storage, 40% of farmers said that they did not store pesticides in a separate room after purchasing or using them. The empty containers were buried or burnt by half of the responders, while the remainder were thrown at the edge of fields or in public dumps. Although the participants were aware of the negative effects on their own health and on the environment caused by the application of pesticides in use, the protection measures by individual equipment were insufficient. A canonical analysis indicates that these behaviors were influenced by the farming experience, the benefit of the agricultural council services, the follow-up of training, and the education level. These variables are important factors in explaining and understanding the dangers to both the environment and health caused by pesticides. The most recorded likely consequences of pesticide exposure were visual impairment (46%), followed by dizziness (44.3%), headache (39.4%), and excessive sweating (34.4%), and 30.2% of participants identified consequent respiratory problems. Extension services targeted at safety and protection measures should be developed and accompanied by educational programs to put farmers' perceptions into practice and encourage them to adopt healthy and environmentally friendly behaviors.

The Parental Pesticide and Offspring's Epigenome Study: Towards an Integrated Use of Human Biomonitoring of Exposure and Effect Biomarkers.

In Morocco, due to the lack of education and the presence of a counterfeit market, pesticides constitute a major problem to be addressed by occupational and environmental health agencies. This paper aims to introduce the PaPOE (Parental Pesticides and Offspring Epigenome) prospective study and its goals, to motivate the study rationale and design, and to examine comprehensively whether multi-residue exposure to commonly used pesticides could induce epigenetic alterations through the oxidative stress pathway. The PaPOE project includes a cross-sectional study assessing the occupational exposure among 300 farmworkers in Meknes, and initiates a birth cohort of 1000 pregnant women. Data and biological samples are collected among farmworkers, and throughout pregnancy, and at birth. Oxidative stress biomarkers include Glutathione, Malondialdehyde, and 8-OHdG. Global and gene-specific DNA methylation is assessed. The study began enrollment in 2019 and is ongoing. As of 30 June 2021, 300 farmworkers and 125 pregnant women have enrolled. The results are expected to showcase the importance of biomonitoring for understanding individual risks, and to identify a number of regions where DNA methylation status is altered in the pesticides-exposed population, paving the way for an integrated biomonitoring system in Morocco and Africa to assess environmental exposures and their long-term health consequences.